Roman Arch, Keystone Fixation for Facial Bipartition with Monobloc Distraction

Abstract

The Roman arch, keystone fixation modification of a combined facial bipartition with monobloc distraction using internal devices provided a stable construct for advancement, with minimal relapse.

The oculo-auriculo-fronto-nasal syndrome (OAFNS) – Description of a rare and complex craniofacial deformity and its interdisciplinary management before school age

“…Initially the procedure was intended together with midface distraction according to Bradley et al (2008) due to coexisting deficiency. However after model surgery it was clear that medial displacement of both facial halves would result in improved facial projection.…”

Family of Crouzon Syndrome Represents the Evolution of the Frontofacial Monobloc Advancement Technique

“…Our third patient (son) underwent a monobloc distraction associated with facial bipartition 16 with a satisfactory result. Facial bipartition has been combined with frontofacial monobloc advancement to approach the inherent hypertelorbitism that may accompany patients with CS.…”

“…Facial bipartition has been combined with frontofacial monobloc advancement to approach the inherent hypertelorbitism that may accompany patients with CS. 16 The medial mobilization of the hemi halves of the face changed the transversal axis of the orbit and may correct the down-slanting eyes and palpebral fissures, common characteristic of craniofacial dysostosis patients. In addition, it also changes a flat face for a more convex and harmonious shape.…”

“…In addition, it also changes a flat face for a more convex and harmonious shape. 16 The major concern of plastic surgeons regarding this technique 16 has, however, been the midline stability during the distraction process and a potential chance of facial transversal collapse, while the face is pushed forward. Previous authors have shown that sufficient midline stability with rigid fixation allows for a simultaneous facial advancement and medial mobilization.…”

“…Her son was the mildest CS patient among the 3 family members, and at 10 years of age underwent a monobloc distraction associated with facial bipartition and symmetric midline ''V'' wedge resection, which included the central portion of the nasal bone, radix, and midportion of the supraorbital rim according to Bradley et al 16 The Kawamoto midface internal distraction devices (KLS Martin, Jacksonville, FL) were used to advance the face 11 mm. The midline ''V'' wedge resection allows medial mobilization of hemi halves of the face of 12 mm.…”